Table 2.

Clinical preventive services receipt among women, by disability status

Topic areas	Recommended clinical preventive services	Data sources	Service indicators	Prevalence of service receipt (%, standard error)
				Women with disabilities	Women without disabilities
Well visits
Physical examination	The Institute of Medicine recommends at least one well-women preventive care visit annually for adult women to obtain the recommended preventive services [11]	Behavioral Risk Factor Surveillance System (BRFSS), 2006–2010	Women aged 18 years or older who received a routine checkup during the past year	71.6 %, (0.4) [16]	72.4 %, (0.2) [16]
Vision examination	The American Optometric Association (AOA) recommends regular vision examinations for adults aged 18–60 years with no risk factors every 2 years; and adults at aged 60 years or older annually [12]	None identified	None identified
Hearing examination	The American Speech–Language–Hearing Association (ASHA) recommends hearing screening for adults as needed, requested, or when they have conditions that place them at risk for hearing disability (e.g., family history, concern of family member); and for adults at least every decade through age 50 years and at 3-year intervals thereafter [13]	National Health and Nutrition Examination Survey (NHANES) Questionnaire, Sample Person (SP)—Audiometry, 2011–2012	Women who had their hearing tested within the following time frames: <1 year, 1–4 years, 5–9 years, or 10+ years	Data exist but are not analyzed and published for women with disabilities
Preventive services
Teeth cleaning	The American Dental Association (ADA) recommends visiting your dentist regularly for professional cleanings and oral examinations [14]	BRFSS, 2010	Women aged 18 years or older who received a teeth cleaning during the past year	59.4 %, (1.0) [18]	73.5 %, (0.2) [18]
Influenza vaccination	The Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for persons aged six months or older [15]. Note: In 1945, the Influenza trivalent vaccine became commercially available in the United States. In 2010, it included H1N1	BRFSS, 2006–2010	Women aged 18 years or older who received a seasonal flu shot during the past 12 months or the seasonal flu vaccine sprayed in the nose (FluMist™).	39.1 %, (0.6) [16]	35.1 %, (0.3) [16]
Hepatitis A vaccination	The ACIP recommends a 2-dose HepA series for persons aged 12 months or older and those previously unvaccinated for whom immunity is desired [15]. Note: In 1995, the HepA vaccine became commercially available in the United States	NHIS, Sample Adult—Adult Access to Healthcare and Utilization, 2011	Women who have ever received a HepA vaccine series—completed after the second shot is received	Data exist but are not analyzed and published for women with disabilities
Hepatitis B vaccination	The ACIP recommends a 3-dose HepB series for persons aged 6 months or older and those previously unvaccinated for whom immunity is desired [15]. Note: In 1982, the HepB vaccine became commercially available in the United States	BRFSS, 2007	Women aged 18 years or older who have ever received a HepB vaccine series - completed after the third shot is received.	36.7 %, (1.1) [18]	39.4 %, (0.5) [18]
Tetanus, diphtheria, pertussis vaccination	The ACIP recommends a single Tdap dose for adults aged 19–64 years [15]. Note: In 2005, the Tdap booster vaccine for adults became commercially available in the United States	NHIS, Sample Adult—Adult Access to Healthcare and Utilization, 2011	Women who have ever received a pertussis or whooping cough vaccine (TdaP, ADACEL™ or BOOSTRIX™)	Data exist but are not analyzed and published for women with disabilities
Human papilloma virus (HPV) vaccination	The ACIP recommends routine vaccination of Women aged 11 or 12 years with 3 doses of either HPV2 or HPV4. The vaccination series can be started beginning at age 9 years. Vaccination is recommended for Women aged 13–26 years who have not been vaccinated previously or who have not completed the 3-dose series. If a female reaches age 26 years before the vaccination series is complete, remaining doses can be administered after age 26 years [15]. Note: In 2006, the HPV vaccine became commercially available in the United States	#1NHIS, Sample Adult—Adult Access to Healthcare and Utilization, 2013 #2NHANES, Questionnaire, Sample Person (SP)—Immunization, 2011–2012	#1Have you ever received an HPV shot or vaccine (CERVARIX™ or GARDASIL ™)? #2Have you ever received one or more doses of the HPV vaccine (CERVARIX™ or GARDASIL ™)?	Data exist but are not analyzed and published for women with disabilities
Zoster vaccination	ACIP recommends that zoster vaccination begin at age 60 years. The Zoster vaccine is Food and Drug Administration approved for administration as early as age 50 years [15]. Note: In 2006, Zoster vaccine became commercially available in the United States	NHIS, Sample Adult—Adult Access to Healthcare and Utilization, 2011	Women who have ever received a Zoster or Shingles vaccine (Zostavax®)	Data exist but are not analyzed and published for women with disabilities.
Pneumococcal vaccination	The ACIP recommends pneumococcal vaccination of all persons aged 65 years and older; and 1–2 doses of pneumococcal vaccination before age 65 years if some other risk factor is present (e.g., on the basis of medical occupational, lifestyle, or other indications) [15]. Note: In 2000, the 7-valent Pneumococcal vaccine became commercially available in the United States. In 2010, the FDA licensed the 13-valent pneumococcal conjugate vaccine	BRFSS, 2006–2010	Women aged 65 years or older who have ever received a pneumonia vaccine	74.1 %, (0.4) [16]	63.8 %, (0.4) [16]
Aspirin therapy	The U.S. Preventive Services Task Force (USPSTF) recommends the use of aspirin for women aged 55–79 years when the potential benefit of a reduction in ischemic stroke outweighs the potential harm of an increase in gastrointestinal hemorrhage [10]	#1BRFSS Cardiovascular Health (even years only) #2NHIS Sample Adult—Adult Conditions, 2011 #3National Health and Nutrition Evaluation Survey (NHANES) Questionnaire, Sample Person (SP)—Dietary supplements and prescription medication, 2011–2012	#1Women who take aspirin daily or every other day #2Women who are now taking a low-dose aspirin each day to prevent or control heart disease #3Women who take aspirin every day or regularly	Data exist but are not analyzed and published for women with disabilities
Screeening services
Cervical cancer screening	The USPSTF recommends Papanicolaou (Pap) screening every 3 years for women aged 21–65 years, every 5 years for women aged 30–65 years when screened with a combination of Pap and HPV testing [10]	BRFSS, 2010	Women aged 18 years or older who received a Pap test during the past 3 years	78.3 %, (0.8) [16]	82.3 %, (0.4) [16]
Lipid screening	The USPSTF recommends routine lipid disorder screening for women, aged 20–45 years if they have risk factors for coronary heart disease, and all women aged 45 years or older. The National Heart Lung and Blood Institute (NHLBI) recommends routine lipid screening for all adults aged 20 and older every 5 years [10]	BRFSS, 2009	Women aged 20 years or older who received a blood test for cholesterol within the past 5 years	82.1 %, (0.9) [18]	79.3 %, (0.4) [18]
Blood pressure screening	The USPSTF recommends routine blood pressure screening in all adults and treatment with anti-hypertensive medication to prevent incidence of cardiovascular disease [10]	#1NHIS, Sample Adult—Adult Access to Healthcare and Utilization, 2011 #2Medical Expenditure Panel Survey (MEPS)—HC, Preventive Care (AP) Section, 2011	#1Women who, during the past 12 months, received a blood pressure test by a doctor, nurse, or other health professional #2Women who, during the past 12 months, received a blood pressure test by a doctor, nurse or other health professional	Data exist but are not analyzed and published for women with disabilities
Breast cancer screening	The USPSTF recommends mammography screening, with or without clinical breast examination, for women aged 40 years or older every 1–2 years [10]	BRFSS, 2010	Women aged 40 years or older who received a mammogram during the past 2 years.	70.7 %, (0.7) [16]	76.6 %, (0.4) [16]
Diabetes type 2	The USPSTF recommends type 2 diabetes screening in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg. The American Diabetes Association recommends type 2 diabetes screening for adults aged 45 years or older, especially those with a BMI ≥25 kg/m2 every 3 years with a fasting plasma glucose (FPG) measurement. The American Association of Clinical Endocrinologists recommends screening beginning at age 30 years for people at high risk for diabetes [10]	NHANES Questionnaire, Sample Person (SP)—Diabetes, 2011–2012	Women who received a blood test for glucose or diabetes within the past 3 years	Data exist but are not analyzed and published for women with disabilities
Colon cancer screening	The USPSTF recommends colorectal cancer screening using fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy for adults beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary [10]	BRFSS, 2010	Women aged 50 years or older who received sigmoidoscopy or colonoscopy during the past 10 years or a fecal occult blood test (FOBT) during the past year, or both	68 %, (0.6) [18]	66.3 %, (0.5) [18]
Osteoporosis screening	The USPSTF recommends routine Bone Mineral Density (BMD) screening beginning at age 60 years for women at increased risk for osteoporotic fractures; and routine screening for women aged 65 years or older [10]. The USPSTF does not mention screening periodicity	None identified	None identified
Mental health screening	The USPSTF recommends screening adults for depression when supports are in place to assure accurate diagnosis, effective treatment and follow up [10]	None identified	None identified
Screening & Counseling Services
Pregnancy planning screening and counseling	The IOM recommends educating and counseling all women with reproductive capacity about available FDA-approved methods of contraception and sterilization [11]	National Survey of Family Growth (NSFG), 2008	Women aged 15–19 years who received formal education on birth control methods	67 %, (CI not provided) [17]	70 %, (CI not provided) [17]
Tobacco screening and counseling	The USPSTF recommends screening all adults for tobacco use and providing tobacco cessation interventions for those who use tobacco products [10]	NHIS, Sample Adult—Adult Access to Healthcare and Utilization, 2011	Women who received a routine physical examination within the last 3 years and whose provider asked about tobacco use	Data exist but are not analyzed and published for women with disabilities
Alcohol misuse screening and counseling	The USPSTF recommends screening and behavioral counseling interventions to reduce alcohol misuse by adults, including pregnant women, in primary care settings [10]	NHIS, Sample Adult—Adult Access to Healthcare and Utilization, 2011	Women who received a routine physical examination within the last 3 years and whose provider asked about alcohol use	Data exist but are not analyzed and published for women with disabilities
Weight control screening and counseling	The USPSTF recommends screening for obesity among all adults and offering intensive counseling and behavioral interventions to promote sustained weight loss for obese adults [10]. The USPSTF also recommends intensive behavioral dietary counseling for adult patients with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease. Intensive counseling can be delivered by primary care clinicians or by referral to other specialists such as nutritionists or dietitians [10]	MEPS—HC, Preventive Care (AP) section, 2011	Women who have ever received advice from their doctor or other health professional to eat fewer high fat or high cholesterol foods or exercise more	Data exist but are not analyzed and published for women with disabilities
Human Immunodeficiency (HIV) Screening	The USPSTF recommends HIV screening for all adolescents and adults at increased risk for HIV infection [10]	BRFSS, 2006–2010	Women aged 18–64 years who have ever received a test for HIV, including tests of fluid from the mouth, not including tests received as part of a blood donation	51.1 %, (0.6) [16]	42.5 %, (0.2) [16]
Sexually transmitted infections (STI) and human immunodeficiency virus (HIV) counseling	The IOM recommends annual counseling on STIs and HIV for all sexually active women [11]	None identified	None identified
Violence screening & counseling	The IOM recommends screening and counseling women and youth for interpersonal and domestic violence [11]	None identified	None identified
Estrogen replacement therapy (ERT) counseling	The USPSTF recommends ERT benefit and risk counseling by a healthcare provider among all women aged 40 or older. This is also recommended for all peri-and postmenopausal women, or all postmenopausal women by the American College of Obstetrics, American College of Physicians, American Academy of Family Physicians, and American Geriatric Society [10]	NHIS, Sample Adult—Adult Access to Healthcare and Utilization, 2011	Women with symptoms of menopause who have talked with a provider about estrogen replacement to prevent bone loss	Data exist but are not analyzed and published for women with disabilities